Trial helps doctors tell Lewy body dementia from Alzheimer's, Parkinson's

September 21, 2016

Knowing that many clinicians find it difficult to correctly diagnose patients with Lewy body dementia, researchers at The Ohio State University Wexner Medical Center set out to develop a clinical profile for these patients. Their findings are published online in the Journal of Alzheimer's Disease.

The study compared 21 patients with Lewy body dementia to 21 patients with Alzheimer's disease and 21 patients with Parkinson's disease. The patients were carefully matched by age, gender, education, race, degree of , and degree of motor (physical) impairment. Pairs were compared using cognitive, functional, behavioral and motor measures.

"Many clinicians find it difficult to diagnose Lewy body dementia patients, often confusing them and misdiagnosing them as Alzheimer¹s disease or Parkinson¹s disease patients. Our study findings showed that the clinical profiles of Lewy body dementia patients can be differentiated from Alzheimer's and Parkinson's patients," said Dr. Douglas Scharre, director of the division of at Ohio State's Wexner Medical Center and principal investigator of the study. "Since treatments and prognosis differ between these conditions, it's important to correctly diagnose the patient from the start."

Researchers with Ohio State's Center for Cognitive and Memory Disorders found that the diagnosis is likely Lewy body dementia if the patient is characterized by a specific cognitive profile (retrieval memory disturbance and deficits in visuospatial and executive domains), along with axial (trunk/body) posture impairments & gait/balance instability. Compared to Alzheimer's patients, Lewy body dementia patients have more executive and visuospatial deficits and less amnesia and disorientation, and also show more daytime sleepiness, cognitive/behavioral fluctuations, hallucinations and obstructive sleep apnea than either Alzheimer's or Parkinson's patients. Significant correlations were noted between axial motor, balance and gait disturbances and executive functioning, visuospatial abilities and global cognitive deficits.

Lewy body dementia is characterized by Parkinsonism (stiffness and trouble with gait), memory loss, and visual processing difficulties. Fluctuations and visual hallucinations are not uncommon. Mental degradation progresses as in people with Alzheimer's disease. The disease usually appears after age 60.

Lewy bodies are collections of proteins (alpha-synuclein) that accumulate abnormally in the brain, that are not typically seen in Alzheimer's, and are deposited in different parts of the brain than in Parkinson's. These toxic alpha-synuclein proteins accumulate gradually, impact specific brain regions leading to its unique clinical symptoms and disease course, and need to be treated and managed differently than those with Alzheimer's or Parkinson's.

"It's vitally important that patients are correctly diagnosed so that they can be prescribed the proper medications that may help slow down the course of the disease or improve symptoms," Scharre said. The correct diagnosis of Lewy body dementia will prompt evaluation and treatment for commonly co-existing associated conditions such as autonomic conditions, sleep apnea, REM sleep behavior disorder, fluctuations of attention and alertness, gait disturbance and fall risk.

Explore further: What is Lewy body dementia, which robbed robin williams of his sanity?

More information: Douglas W. Scharre et al. Paired Studies Comparing Clinical Profiles of Lewy Body Dementia with Alzheimer's and Parkinson's Diseases, Journal of Alzheimer's Disease (2016). DOI: 10.3233/JAD-160384

Related Stories

What is Lewy body dementia, which robbed robin williams of his sanity?

November 20, 2015
Oscar-winning actor and comedian Robin Williams died in August 2014 of suicide. His death was not due to substance abuse or suicidal tendencies, as some had speculated in the media. Williams' wife, Susan, told ABC's "Good ...

FAU site for first US clinical trial for Lewy Body dementia

April 21, 2016
Florida Atlantic University's Charles E. Schmidt College of Medicine is spearheading the South Florida site for the first U.S. clinical trial for Lewy body dementia (LBD), the second-most common dementia after Alzheimer's ...

Parkinson's study could pave way for early detection test

August 29, 2016
A test that can detect Parkinson's disease in the early stages of the illness has moved a step closer.

Acting out dreams linked to development of dementia, study finds

March 21, 2013
The strongest predictor of whether a man is developing dementia with Lewy bodies—the second most common form of dementia in the elderly—is whether he acts out his dreams while sleeping, Mayo Clinic researchers have discovered. ...

Researchers identify tissue biomarker for dementia with lewy bodies and Parkinson's disease

April 11, 2016
Accurate diagnosis of Parkinson's disease, and the related disease "dementia with Lewy bodies," can be difficult in the early stages of both conditions. While brain biopsies can be more accurate, the risk of complications ...

Two in ten Alzheimer's cases may be misdiagnosed

July 26, 2016
(HealthDay)—Alzheimer's disease is often misdiagnosed, possibly causing undue stress for those who don't have the disease but are told they do, and delays in treatment for others, two new studies reveal.

Recommended for you

Artificial intelligence predicts dementia before onset of symptoms

August 22, 2017
Imagine if doctors could determine, many years in advance, who is likely to develop dementia. Such prognostic capabilities would give patients and their families time to plan and manage treatment and care. Thanks to artificial ...

Chronic stress induces fatal organ dysfunctions via a new neural circuit

August 22, 2017
Hokkaido University researchers revealed that fatal gut failure in a multiple sclerosis (MS) mouse model under chronic stress is caused by a newly discovered nerve pathway. The findings could provide a new therapeutic strategy ...

Noninvasive eye scan could detect key signs of Alzheimer's years before patients show symptoms

August 17, 2017
Cedars-Sinai neuroscience investigators have found that Alzheimer's disease affects the retina—the back of the eye—similarly to the way it affects the brain. The study also revealed that an investigational, noninvasive ...

Could olfactory loss point to Alzheimer's disease?

August 16, 2017
By the time you start losing your memory, it's almost too late. That's because the damage to your brain associated with Alzheimer's disease (AD) may already have been going on for as long as twenty years. Which is why there ...

New Machine Learning program shows promise for early Alzheimer's diagnosis

August 15, 2017
A new machine learning program developed by researchers at Case Western Reserve University appears to outperform other methods for diagnosing Alzheimer's disease before symptoms begin to interfere with every day living, initial ...

Brain scan study adds to evidence that lower brain serotonin levels are linked to dementia

August 14, 2017
In a study looking at brain scans of people with mild loss of thought and memory ability, Johns Hopkins researchers report evidence of lower levels of the serotonin transporter—a natural brain chemical that regulates mood, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.